Welcome to our guide on understanding health insurance in Portugal! Whether you’re a local or an expat, this information will help you make informed decisions about your healthcare coverage.
Overview: Healthcare in Portugal
Portugal boasts a solid public healthcare system, but many people opt for private health insurance too. Why? Because as great as the public system is, it’s often over-burdened and under-staffed.
- Health insurance normally cuts the cost of using private hospitals, which don’t suffer from these problems to the same extent.
- For newcomers to Portugal, particularly those from outside the EU/EEA/Switzerland, private health insurance isn’t just a nice-to-have – it’s often a must-have. It’s typically required for your AIMA appointment, e.g. if you’re entering on a D7 or D8 visa.
But here’s a little secret: once you get your SNS number, some folks choose to cancel their private insurance and rely solely on the public system.
Should you do this? The increasing wisdom is no, but everyone’s situation is different.
Public vs. Private: What’s the Difference?
Once you’re a resident, you’re free to use the public healthcare system. You can also pay out-of-pocket for private hospital care if you prefer.
So why consider private insurance?
While the public system handles emergencies and major illnesses like cancer brilliantly, private hospitals often shine for routine procedures. Private care usually means shorter wait times, though it’s not always instant. You’re also more likely to find English-speaking doctors and maybe even enjoy a bit more TLC.
It’s all about weighing your options and priorities.
Costs
Health insurance in Portugal is not expensive, especially when compared to the USA. As an example, the following costs are what you could expect to pay for the highest level of coverage in Portugal.
This would include €1 million towards hospitalization (per year/per person), €5,000 doctor’s appointments, €1 million critical illness outside of Portugal. This also include €1,000 per year per person for dental. This quote was given in a Portugalist webinar in July 2024.
Single/Couple |
Age(s) |
Costs |
Couple |
35 |
€266 per month (for both) |
Couple |
55 |
€355 per month (for both) |
Couple |
64 |
€530 per month (for both) |
I left the US because as a retired firefighter we don’t have access to health insurance until we are 65yo. My wife and I were paying over $1000 a month for health insurance. I feared becoming ill and loosing all we worked for due to the sky high price of any hospital procedure. Here a policy for us is 165 euros a month. I have had an operation in a private hospital, 5 star service. – Comment on Portugalist
- Family members: Always
- Budgeting: In recent years, the cost of premiums have increased for health insurance. Insurance broker Fernando Mendes recommends factoring premium increases into your budget. For example, if the max you can afford is €250 per month, you should expect this to increase with inflation (and above). If that’s going to stretch you too thin, consider cutting back elsewhere or even choosing a different plan.
- Monthly or annual: Fernando also suggests monthly payments as opposed to annual payments, even if there’s a small discount for annual payments. This is because plans change and it allows you to easily cancel your plan and not be out of pocket.
Pre-existing Conditions & Medications
Let’s talk about a tricky topic: pre-existing conditions. It can be a bit of a puzzle when it comes to insurance coverage. Many insurers might exclude these conditions or make you wait before covering them. But don’t lose hope!
- MGEN is the main insurer that often covers pre-existing conditions. A couple of others might too, depending on your situation.
- Here’s some good news: even if your insurance doesn’t cover pre-existing conditions, you’re not out of luck. The Portuguese state subsidizes prescriptions for these conditions, sometimes making them very affordable or even free if they’re life-threatening.
Don’t be discouraged if an insurer says they don’t cover pre-existing conditions. You can still get the policy; it just won’t cover those specific issues. Why? Because Portugal’s public health system has got your back for those.
Insurance for Older Residents
Let’s be honest – finding private health insurance in Portugal gets tougher after 70.
- MGEN is often the go-to provider for this age group, but it can be pricey.
- Some folks choose to self-insure at this point, essentially saving money instead of paying an insurer.
Don’t forget: you still have the public system at this point. You can also pay to use private hospitals.
Buying Health Insurance
- You can buy Portuguese health insurance once you have a Portuguese NIF (tax number), Portuguese bank account, and address in Portugal. You don’t even need to be a resident, and could purchase it before you move to Portugal.
- It’s doesn’t make a difference whether you’re an EU citizen or not. You simply have to have the three requirements – a NIF, Portuguese bank account, and address in Portugal.
- Deciding when to start your coverage is a balancing act. Consider things like waiting periods and when you’ll arrive in Portugal so that you have a continuation of coverage.
- Be careful about buying insurance from banks or brokers without understanding how it fits your needs.
- Sometimes, it’s smart to get insured early – even before moving to Portugal or have your AIMA appointment – to get past those pesky waiting periods.
The largest Portuguese providers are:
Other names include:
It’s a good idea to shop around and speak to a broker as well as services like Serenity Portugal.
Understanding Waiting Periods
Most health insurance policies have waiting periods, usually 60-90 days for routine stuff. But don’t fret – emergency and accident coverage typically kicks in right away, even with new policies.
Some insurers might waive waiting periods if you’re switching from another plan in another country, so it’s worth asking about.
Pregnancy is an example of something that typically isn’t covered until around a year after your policy begins. If you become pregnant before that, you can give birth in a public hospital. However, it may also be worth speaking to a private hospital or your health insurance provider as insurance broker Fernando Mendes notes.
I had a client from Canada who was already a few months pregnant. She didn’t think she would be able to use a private hospital as her baby was due in around 6 months. However, she had a private health insurance plan. She asked the hospital for a quote out-of-pocket and was quoted €4,500 but due to the fact she had a private health insurance plan, they offered her a discount of €1,200.
Without insurance, this is still considerably cheaper than what you would expect to pay in the US and likely in the UK too. However, with insurance it’s definitely cheaper.
What to Consider When Choosing Health Insurance in Portugal
Selecting the right health insurance can feel like a puzzle, but let’s break it down into manageable pieces. Here are some key factors to mull over as you decide which insurance product fits your needs best.
Check Your Local Healthcare Providers
Take a moment to check which insurance providers are accepted at the hospitals, dentists, and other healthcare services in your area. It’s all about making your life easier when you need care.
Google Maps will give you a lot of the information you need. Alternatively, look out for common names of private hospital chains such as CUF, LUZ, Lusíadas,
Joaquim Chaves, and Groupo HPA, to name a few.
International Coverage: Globe-Trotter’s Delight
- Are you a frequent flyer or considering a move in the near future? If so, you might want to look into providers with a more international focus. Yes, it might be pricier, but the peace of mind could be worth it if you’re often on the go.
- If your health insurance doesn’t offer great international coverage, you should purchase travel insurance for the countries you’re visiting.
- Some Americans choose to continue paying for Medicare or health insurance plans in the US, at least until they’re confident they won’t live there again.
Pregnancy: Public or Private?
While residents can give birth for free using the public system, many opt for private hospitals. Why? More privacy and often more personalized care. It’s worth considering if you’re planning to grow your family.
However, it’s worth noting that coverage for giving birth typically doesn’t start until around a year after you take out the policy.
Don’t worry though: you will still be able to use the public system as well.
Dental Care
Dental care isn’t typically covered by the public system. While a check-up won’t break the bank (around €30-50), insurance can reduce those costs to a small co-pay. However, whether it’s worth adding it is an individual decision.
“If you are in the lucky position where you only need one or two checkups per year and are otherwise very healthy in terms of dental, it’s probably not financially not worth it to take out dental coverage. What you’ll pay extra to get €250-€1,000 worth of dental coverage is unlikely to be worth it given the average dental checkup is around €30-€50.” – Fernando Mendes (Insurance broker)
Vision
- Public: Vision care is indeed covered under the public healthcare system in Portugal. It’s considered a medical service, which means you can get your eyes checked without breaking the bank. But here’s the catch: you may have to wait several months for an appointment. Unfortunately, the public system typically also doesn’t cover prescription glasses.
- Private: The coverage for vision-related treatments and prescription glasses depends on the policy you choose. But here’s a little nugget of good news: most private insurance plans consider an eye exam just like any other doctor’s appointment. This means it’s usually covered, whether you’re seeing a general physician or an eye specialist.
“Glasses are included on the higher plans, but they are very expensive and so it’s probably not worth it.” – Fernando Mendes (Insurance broker)
Pre-existing Conditions: Not a Deal-Breaker
Most insurers shy away from covering pre-existing conditions on new policies. However, some might offer coverage if you can prove you’re already insured elsewhere. If that’s not an option, MGEN is a popular choice for those with pre-existing conditions.
Age Restrictions: Plan Ahead
Many insurers have age caps, often around 70. If you’re approaching this age, you might want to start your policy earlier or seek out a provider that caters to older adults. It’s all about planning ahead for your golden years.
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